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Dr. Andrew Rynne
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Article Home Eye Problems Hypertensive retinopathy

Hypertensive retinopathy

Hypertensive retinopathy is the damage of the retina of the eye due to high blood pressure. In hypertensive retinopathy the high blood pressure over long time causes damage to the small blood vessels of the eye.


When the blood pressure becomes high the retina may be damaged. This damages the small blood vessels in the retina making the walls of the blood vessel to thicken. This decrease the amount of blood which can flow in to them.

Symptoms of hypertensive retinopathy

  • Decreased vision
  • Gradual loss of vision
  • Headaches

Signs of hypertensive retinopathy

Narrowing of the small blood vessel is seen. According to this it is graded in to 4 grades

  • Grade I: 3/4 of normal caliber, in this there is minimal narrowing of the blood vessels of retina.
  • Grade II: 1/2 normal calibers. Narrowing of the retinal arteries with focal narrowing and arterio venous nicking is seen
  • Grade III: 1/3 normal caliber. Along with the above changes there will be retinal hemorrhages, hard exudation and cotton-wool spots are seen.
  • Grade IV: Thread like or invisible blood vessels. All the above findings with swelling of optic nerve head is seen

Other signs seen in hypertensive retinopathy

  • Arteriovenous crossings
  • Copper wire arterioles
  • Silver wire arterioles
  • Cotton wool spots
  • Flame shaped hemorrhages

Tests and diagnosis

  • Retinal examination
  • Ophthalmoscopy
  • Fluorescein angiography


Control of high blood pressure is the only treatment for hypertensive retinopathy.